Urolithiasis is one of the most common clinical diseases in urology. Among them, kidney stones and ureteral stones are particularly common, accounting for more than 70% of clinical stone patients. The etiology of stones is not yet well understood, but it is believed that stone formation is related to a combination of factors such as geographical environment, living habits, dietary structure, metabolic function and endocrine status. The treatment of kidney stones has developed greatly in the past 30 years, from the early single open surgery, which is often referred to as “open surgery”, to various treatment methods such as extracorporeal shock wave lithotripsy, ureteroscopic lithotripsy, percutaneous nephrolithotripsy, laparoscopic lithotripsy and robot-assisted surgery. In particular, percutaneous nephrolithotomy (also known as PCNL surgery). It is favored by urological clinicians for its small trauma, good treatment effect and fast recovery after surgery, and has brought good news to the majority of kidney stone patients. As early as the 1980s, percutaneous nephrolithotomy was already used in clinical practice, and it was reported in 1984 in China. The development of percutaneous nephrolithotomy was limited due to various reasons of equipment and technology, as well as the high incidence of complications such as intraoperative and postoperative bleeding and urinary extravasation, and the high risk. Until the 1990s, with the deepening of clinicians’ understanding of the PCNL procedure, especially the great improvement of intracavitary lithotripsy equipment, this procedure gradually replaced open surgery as an effective method for treating large diameter kidney stones. Through continuous clinical practice and research, useful attempts and improvements have been made in all aspects of PCNL for kidney stones to reduce complications such as bleeding and urinary extravasation and to improve the stone removal rate. The use of B-ultrasound, X-ray, CT or B-ultrasound combined with X-ray guidance for percutaneous renal puncture has played an important role in the treatment of kidney stones by PCNL. In particular, the EMS third generation lithotripsy system, which combines pneumatic ballistics and ultrasound, has become a more ideal tool for intracavitary lithotripsy in recent years. Although a new type of lithotripter with laser combined with suction facility has been reported in 2008, it has only been tested in vitro and has not yet been applied in clinical treatment. PCNL is suitable for almost all renal stones requiring open surgery, including stones that are difficult to be crushed by extracorporeal shock waves and failed to be treated, large upper ureteral stones, and special types of renal stones, such as pediatric renal stones, isolated kidney, horseshoe kidney, and transplanted kidney combined with stones. Nevertheless, those with systemic bleeding disorders, severe diabetes mellitus or hypertension, renal tuberculosis, oversized liver and spleen, as well as severe deformities and excessive obesity still add to the risk or difficulty of the procedure and become clinical contraindications. Nephrostomy tubes and double J-tubes are often left in place after PCNL surgery to keep the urinary drainage open and to discharge small stones and coagulation residues in the kidney; if postoperative mucosal bleeding occurs in the renal pelvis, the nephrostomy tubes can be clamped for a short time to increase the pressure in the pelvis and produce hemostasis. However, recent studies have shown that tubeless PCNL (that is, no nephrostomy tube, double J tube) causes less postoperative pain, faster recovery, and shorter hospital stay, and has been tried by more and more doctors. However, it has strict indications and should be applied selectively according to the specific surgical condition of the patient. Many surgeons are exploring the use of miniaturized instruments in order to reduce surgical trauma and bleeding. The clinical application of F14-16 microchannel PCNL is becoming more and more widespread at home and abroad, and it is named as “percutaneous nephrostomy for stone extraction”. In China, Wu Kaijun and Li Xun have been using this procedure since the 1990s to treat kidney stones, and more than 5000 cases have been successfully reported so far. In recent years, this procedure has been widely used in many large and medium-sized medical institutions in China, and with the increasing clinical experience, minimally invasive percutaneous nephrolithotomy is not only used for the treatment of single kidney stones, but also for more complicated stones such as large diameter kidney cast stones, stones that failed ESWL or ureteroscopic surgery. Therefore, percutaneous nephrolithotomy has become the first choice for kidney stone treatment in China and abroad. We believe that with the continuous progress of science and technology and the emergence of new intracavitary lithotripsy equipment, this procedure will be improved and play an important role in the surgical treatment of kidney stone patients.